Utvidet prevalensundersøkelse 4. kvartal Nettundervisning

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1 Utvidet prevalensundersøkelse 4. kvartal 2017 Nettundervisning

2 Agenda Bakgrunn Hensikt Praktisk gjennomføring Alle infeksjoner Prosess/strukturindikatorer gjennomgang Spørsmålsrunde 1

3 Bakgrunn Europeisk punktprevalensundersøkelse (PPS) av HAI og AB-bruk i sykehus i regi av ECDC Norsk deltakelse i europeisk PPS I Norsk deltakelse i europeisk PPS II > kompromiss: - norske data gjenbrukes/konverteres (4. kvartal 2017) - registrerer alle helsetjenesteassosierte infeksjoner (de frivillige i PIAH) - deltar i indikatorundersøkelsen som tillegg til prevalensen Oppdrag fra HOD - situasjonsbeskrivelse 2

4 Hensikt Konvertering av våre data betyr at vi kan levere i hht NOIS-forskrift komplette aggregerte data om de fleste HAI komplett ABbruk på individnivå Gjøre prevalens på alle HAI uten å måtte gjøre PPSen på individnivå (er allerede i PIAHnett) Indikatorundersøkelsen gi oversikt over de core components som fagmiljøet, ECDC og WHO mener er viktige for godt smittevern Eget sykehus Sammenlignet nasjonalt og Europa Indikatorundersøkelsen del av situasjonsbeskrivelsen til HOD Europeiske data fra PPS brukes, også politisk høy deltakelse fra Norge gir et riktigere bilde 4

5 Alle helsetjenesteassosierte infeksjoner I tillegg til de obligatoriske infeksjoner registreres de frivillige, beskrevet i malen og PIAHnett: I henhold til de europeiske definisjonene Ligger på (engelsk) Husk! Kun helsetjenesteassosierte 5

6 Helsetjenesteassosiert infeksjon Fra dag 3 Fra dag 1 for POSI (HAI) Fra dag 1 hvis invasivt utstyr ble lagt inn og resulterer i HAI før dag 3 Fra dag 1 hvis reinnleggelse innen 48 timer Fra dag 1 hvis reinnlagt med C.diff innen 28 dager 6

7 Aktiv HAI? Med andre ord Oppstart av HAI Dag 3 og utover ELLER Innleggelse, dag 1 eller dag 2 (POSI) ELLER Innleggelse, dag 1 eller dag 2 OG pasient utskrevet fra sykehus i foregående 48 timer ELLER Innleggelse, dag 1 eller dag 2 OG pasient utskrevet fra sykehus i foregående 28 dager (CDiff) ELLER Dag 1 eller dag 2 OG pasient fikk innlagt relevant utstyr forut for infeksjon OG Kasus definisjon Samsvarer med kasusdefinisjonen på undersøkelsestidspunktet ELLER Pasienten står på antibiotika OG HAI har tidligere samsvart med kasusdef. mellom dag 1 av AB-beh og undersøkelsestidspunktet 7

8 Praktisk gjennomføring - Alle infeksjoner Prevalensundersøkelsen 4. kvartal 2017 I henhold til de europeiske definisjonene Ligger på (engelsk) Registreres som vanlig i PIAHnett xml-spesifikasjon foreligger fra før FHI overfører data til ECDC anonymisert ECDC konverterer og legger til europeisk database, lager rapporter 8

9 PIAHnett 9

10 Til ev. bruk ved prevalensundersøkelsen - ligger i Word på 10

11 Praktisk gjennomføring - Prosess- og strukturindikatorer Del av ECDC PPS-protokoll Deltar på sykehusnivå (som i PIAH) Smittevernpersonell samler data Innsamles ila høsten, noe ved prevalensundersøkelsen Data sendes FHI ved å scanne papirskjemaene og sende på e-post - skriv tydelig! Kvalitetssikring FHI - sykehusene FHI registrerer anonymisert i ECDCs system HelicsWin ECDC lager rapporter 11

12 Gjennomgang indikatorene Tre skjemaer Beskrevet på engelsk på s i europeisk PPS-mal En «veiledning» på norsk er sendt på epost (hvis ikke, ta kontakt med prevalens@fhi.no) 12

13 Hospital data 1/3 p.10 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H1. Hospital data 1/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Hospital size (total number of beds) Number of acute care beds Number of ICU beds Exclusion of wards for PPS? No Yes, please specify which ward types were excluded: Number of discharges/admissions in year Number of patient-days in year Alcohol hand rub consumption liters/year N observed hand hygiene opportunities/year Number of blood culture sets/year Number of stool tests for CDI/year Number Year data Inc./ Total (1) Total number of beds in included wards: Total number of patients included in PPS: Hospital type Primary Secondary Tertiary Specialised, specify : Hospital ownership: Public Private, not-for-profit Private, for profit Other/unknown Hospital is part of administrative hospital group (AHG): No Yes if yes: Data apply to: Hospital site only AHG code: N of beds AHG: Total All hospitals in AHG AHG type: Prim Sec Tert Spec Acute care beds Number of FTE infection control nurses Number of FTE infection control doctors Number of FTE antimicrobial stewardship Number of FTE registered nurses Number of FTE nursing assistants Number of FTE registered nurses in ICU Number of FTE nursing assistants in ICU N of airborne infection isolation rooms (1) Data were collected for Included wards only (Inc, = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc ; N=Number PPS Protocol: Standard Light Is the hospital part of a national representative sample of hospitals? No Yes Unknown 13

14 Hospital data 1/3 p.10 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H1. Hospital data 1/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Hospital size (total number of beds) Number of acute care beds Number of ICU beds Exclusion of wards for PPS? No Yes, please specify which ward types were excluded: Number of discharges/admissions in year Number of patient-days in year Alcohol hand rub consumption liters/year N observed hand hygiene opportunities/year Number of blood culture sets/year Number of stool tests for CDI/year Number Year data Inc./ Total (1) Total number of beds in included wards: Total number of patients included in PPS: Hospital type Primary Secondary Tertiary Specialised, specify : Hospital ownership: Public Private, not-for-profit Private, for profit Other/unknown Hospital is part of administrative hospital group (AHG): No Yes if yes: Data apply to: Hospital site only AHG code: N of beds AHG: Total All hospitals in AHG AHG type: Prim Sec Tert Spec Acute care beds Number of FTE infection control nurses Number of FTE infection control doctors Number of FTE antimicrobial stewardship Number of FTE registered nurses Number of FTE nursing assistants Number of FTE registered nurses in ICU Number of FTE nursing assistants in ICU N of airborne infection isolation rooms (1) Data were collected for Included wards only (Inc, = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc ; N=Number PPS Protocol: Standard Light Is the hospital part of a national representative sample of hospitals? No Yes Unknown 14

15 Hospital data 1/3 p.10 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H1. Hospital data 1/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Hospital size (total number of beds) Number of acute care beds Number of ICU beds Exclusion of wards for PPS? No Yes, please specify which ward types were excluded: Number of discharges/admissions in year Number of patient-days in year Alcohol hand rub consumption liters/year N observed hand hygiene opportunities/year Number of blood culture sets/year Number of stool tests for CDI/year Number Year data Inc./ Total (1) Total number of beds in included wards: Total number of patients included in PPS: Hospital type Primary Secondary Tertiary Specialised, specify : Hospital ownership: Public Private, not-for-profit Private, for profit Other/unknown Hospital is part of administrative hospital group (AHG): No Yes if yes: Data apply to: Hospital site only AHG code: N of beds AHG: Total All hospitals in AHG AHG type: Prim Sec Tert Spec Acute care beds Number of FTE infection control nurses Number of FTE infection control doctors Number of FTE antimicrobial stewardship Number of FTE registered nurses Number of FTE nursing assistants Number of FTE registered nurses in ICU Number of FTE nursing assistants in ICU N of airborne infection isolation rooms (1) Data were collected for Included wards only (Inc, = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc ; N=Number PPS Protocol: Standard Light Is the hospital part of a national representative sample of hospitals? No Yes Unknown 15

16 Hospital data 1/3 p.10 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H1. Hospital data 1/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Hospital size (total number of beds) Number of acute care beds Number of ICU beds Exclusion of wards for PPS? No Yes, please specify which ward types were excluded: Number of discharges/admissions in year Number of patient-days in year Alcohol hand rub consumption liters/year N observed hand hygiene opportunities/year Number of blood culture sets/year Number of stool tests for CDI/year Number Year data Inc./ Total (1) Total number of beds in included wards: Total number of patients included in PPS: Hospital type Primary Secondary Tertiary Specialised, specify : Hospital ownership: Public Private, not-for-profit Private, for profit Other/unknown Hospital is part of administrative hospital group (AHG): No Yes if yes: Data apply to: Hospital site only AHG code: N of beds AHG: Total All hospitals in AHG AHG type: Prim Sec Tert Spec Acute care beds Number of FTE infection control nurses Number of FTE infection control doctors Number of FTE antimicrobial stewardship Number of FTE registered nurses Number of FTE nursing assistants Number of FTE registered nurses in ICU Number of FTE nursing assistants in ICU N of airborne infection isolation rooms (1) Data were collected for Included wards only (Inc, = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc ; N=Number PPS Protocol: Standard Light Is the hospital part of a national representative sample of hospitals? No Yes Unknown 16

17 Hospital data 1/3 p.10 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H1. Hospital data 1/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Hospital size (total number of beds) Number of acute care beds Number of ICU beds Exclusion of wards for PPS? No Yes, please specify which ward types were excluded: Number of discharges/admissions in year Number of patient-days in year Alcohol hand rub consumption liters/year N observed hand hygiene opportunities/year Number of blood culture sets/year Number of stool tests for CDI/year Number Year data Inc./ Total (1) Total number of beds in included wards: Total number of patients included in PPS: Hospital type Primary Secondary Tertiary Specialised, specify : Hospital ownership: Public Private, not-for-profit Private, for profit Other/unknown Hospital is part of administrative hospital group (AHG): No Yes if yes: Data apply to: Hospital site only AHG code: N of beds AHG: Total All hospitals in AHG AHG type: Prim Sec Tert Spec Acute care beds Number of FTE infection control nurses Number of FTE infection control doctors Number of FTE antimicrobial stewardship Number of FTE registered nurses Number of FTE nursing assistants Number of FTE registered nurses in ICU Number of FTE nursing assistants in ICU N of airborne infection isolation rooms (1) Data were collected for Included wards only (Inc, = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc ; N=Number PPS Protocol: Standard Light Is the hospital part of a national representative sample of hospitals? No Yes Unknown 17

18 Hospital data 1/3 p.10 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H1. Hospital data 1/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Hospital size (total number of beds) Number of acute care beds Number of ICU beds Exclusion of wards for PPS? No Yes, please specify which ward types were excluded: Number of discharges/admissions in year Number of patient-days in year Alcohol hand rub consumption liters/year N observed hand hygiene opportunities/year Number of blood culture sets/year Number of stool tests for CDI/year Number Year data Inc./ Total (1) Total number of beds in included wards: Total number of patients included in PPS: Hospital type Primary Secondary Tertiary Specialised, specify : Hospital ownership: Public Private, not-for-profit Private, for profit Other/unknown Hospital is part of administrative hospital group (AHG): No Yes if yes: Data apply to: Hospital site only AHG code: N of beds AHG: Total All hospitals in AHG AHG type: Prim Sec Tert Spec Acute care beds Number of FTE infection control nurses Number of FTE infection control doctors Number of FTE antimicrobial stewardship Number of FTE registered nurses Number of FTE nursing assistants Number of FTE registered nurses in ICU Number of FTE nursing assistants in ICU N of airborne infection isolation rooms (1) Data were collected for Included wards only (Inc, = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc ; N=Number PPS Protocol: Standard Light Is the hospital part of a national representative sample of hospitals? No Yes Unknown 18

19 Guideline Care bundle Training Checklist Audit Surveillance 19 Feedback Hospital data 2/3 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H2. Hospital data 2/3 Hospital code: Does your hospital have the following in place for HAI prevention or antimicrobial stewardship? (Y/N/U) Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Infection prevention and control (IPC) programme: Is there an annual IPC plan, approved by the hospital CEO or a senior executive officer? Yes No Is there an annual IPC report, approved by the hospital CEO or a senior executive officer? Yes No Participation in surveillance networks: In the previous year, which surveillance networks did your hospital participate in? (tick all that apply) SSI ICU CDI Antimicrobial resistance Antimicrobial consumption Other, specify Microbiology/diagnostic performance: At weekends, can clinicians request routine microbiological tests and receive back results? Clinical tests: Saturday Sunday Screening tests: Saturday Sunday CEO: Chief Executive Officer, Managing Director; SSI: surgical site infections; ICU: intensive care unit (HAIs in ICUs); CDI: Clostridium difficile infections. Pneumonia Bloodstream infections Urinary tract infections Antimicrobial use Pneumonia Bloodstream infections Surgical site infections Urinary tract infections Antimicrobial use ICU Hospital-wide / other wards Pneumonia, bloodstream infections and urinary tract infections: healthcareassociated and/or device-associated; Care bundle: 3-5 evidence-based practices to improve patient outcome; Training: training or education; Checklist: selfapplied; Audit: external process (process surveillance, observations ) Comments/observations:

20 Guideline Care bundle Training Checklist Audit Surveillance Feedback Hospital data 2/3 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H2. Hospital data 2/3 Hospital code: Does your hospital have the following in place for HAI prevention or antimicrobial stewardship? (Y/N/U) Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Infection prevention and control (IPC) programme: Is there an annual IPC plan, approved by the hospital CEO or a senior executive officer? Yes No Is there an annual IPC report, approved by the hospital CEO or a senior executive officer? Yes No Participation in surveillance networks: In the previous year, which surveillance networks did your hospital participate in? (tick all that apply) SSI ICU CDI Antimicrobial resistance Antimicrobial consumption Other, specify Microbiology/diagnostic performance: At weekends, can clinicians request routine microbiological tests and receive back results? Clinical tests: Saturday Sunday Screening tests: Saturday Sunday CEO: Chief Executive Officer, Managing Director; SSI: surgical site infections; ICU: intensive care unit (HAIs in ICUs); CDI: Clostridium difficile infections. Pneumonia Bloodstream infections Urinary tract infections Antimicrobial use Pneumonia Bloodstream infections Surgical site infections Urinary tract infections Antimicrobial use ICU Hospital-wide / other wards Pneumonia, bloodstream infections and urinary tract infections: healthcareassociated and/or device-associated; Care bundle: 3-5 evidence-based practices to improve patient outcome; Training: training or education; Checklist: selfapplied; Audit: external process (process surveillance, observations ) Comments/observations: 20

21 Guideline Care bundle Training Checklist Audit Surveillance Feedback Hospital data 2/3 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H2. Hospital data 2/3 Hospital code: Does your hospital have the following in place for HAI prevention or antimicrobial stewardship? (Y/N/U) Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Infection prevention and control (IPC) programme: Is there an annual IPC plan, approved by the hospital CEO or a senior executive officer? Yes No Is there an annual IPC report, approved by the hospital CEO or a senior executive officer? Yes No Participation in surveillance networks: In the previous year, which surveillance networks did your hospital participate in? (tick all that apply) SSI ICU CDI Antimicrobial resistance Antimicrobial consumption Other, specify Microbiology/diagnostic performance: At weekends, can clinicians request routine microbiological tests and receive back results? Clinical tests: Saturday Sunday Screening tests: Saturday Sunday CEO: Chief Executive Officer, Managing Director; SSI: surgical site infections; ICU: intensive care unit (HAIs in ICUs); CDI: Clostridium difficile infections. Pneumonia Bloodstream infections Urinary tract infections Antimicrobial use Pneumonia Bloodstream infections Surgical site infections Urinary tract infections Antimicrobial use ICU Hospital-wide / other wards Pneumonia, bloodstream infections and urinary tract infections: healthcareassociated and/or device-associated; Care bundle: 3-5 evidence-based practices to improve patient outcome; Training: training or education; Checklist: selfapplied; Audit: external process (process surveillance, observations ) Comments/observations: 21

22 Guideline Care bundle Training Checklist Audit Surveillance Feedback Hospital data 2/3 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H2. Hospital data 2/3 Hospital code: Does your hospital have the following in place for HAI prevention or antimicrobial stewardship? (Y/N/U) Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Infection prevention and control (IPC) programme: Is there an annual IPC plan, approved by the hospital CEO or a senior executive officer? Yes No Is there an annual IPC report, approved by the hospital CEO or a senior executive officer? Yes No Participation in surveillance networks: In the previous year, which surveillance networks did your hospital participate in? (tick all that apply) SSI ICU CDI Antimicrobial resistance Antimicrobial consumption Other, specify Microbiology/diagnostic performance: At weekends, can clinicians request routine microbiological tests and receive back results? Clinical tests: Saturday Sunday Screening tests: Saturday Sunday CEO: Chief Executive Officer, Managing Director; SSI: surgical site infections; ICU: intensive care unit (HAIs in ICUs); CDI: Clostridium difficile infections. Pneumonia Bloodstream infections Urinary tract infections Antimicrobial use Pneumonia Bloodstream infections Surgical site infections Urinary tract infections Antimicrobial use ICU Hospital-wide / other wards Pneumonia, bloodstream infections and urinary tract infections: healthcareassociated and/or device-associated; Care bundle: 3-5 evidence-based practices to improve patient outcome; Training: training or education; Checklist: selfapplied; Audit: external process (process surveillance, observations ) Comments/observations: 22

23 Hospital data 3/3 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H3. Hospital data 3/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Optional: ward indicators collected at hospital-wide level: Number of beds with AHR dispensers at point of care Number of beds assessed for presence of AHR dispensers Number of patient rooms in hospital Number of single patient rooms in hospital Number of single patient rooms with individual toilet and shower in hospital Number of beds occupied at 00:01 on the day of PPS Number of beds assessed for occupancy at 00:01 on the day of PPS Number Inc./ Total (1) (1) Data were collected for Included wards only (Inc = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc In your hospital, do healthcare workers (HCW) carry AHR dispensers (e.g. in their pockets)? (if yes, please estimate percentage) O No O >0-25% of HCW O >25-50% of HCW O >50-75% of HCW O >75% of HCW O Yes, percentage unknown Is there a formal procedure to review the appropriateness of an antimicrobial within 72 hours from the initial order in the hospital (post-prescription review)? O Yes, in all wards O Yes, in selected wards only O Yes, in ICU only O No AHR = Alcohol hand rub; Number of beds assessed for presence of AHR dispensers and Number of beds assessed for occupancy at 00:01 on the day of PPS = denominator data, typically same number as the total number of beds in the hospital; ICU=intensive care unit. 23

24 Hospital data 3/3 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H3. Hospital data 3/3 Hospital code: X Optional: ward indicators collected at hospital-wide level: Number of beds with AHR dispensers at point of care Number of beds assessed for presence of AHR dispensers Number of patient rooms in hospital Number of single patient rooms in hospital Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Number of single patient rooms with individual toilet and shower in hospital Number of beds occupied at 00:01 on the day of PPS Number of beds assessed for occupancy at 00:01 on the day of PPS Number Inc./ Total (1) (1) Data were collected for Included wards only (Inc = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc In your hospital, do healthcare workers (HCW) carry AHR dispensers (e.g. in their pockets)? (if yes, please estimate percentage) O No O >0-25% of HCW O >25-50% of HCW O >50-75% of HCW O >75% of HCW O Yes, percentage unknown Is there a formal procedure to review the appropriateness of an antimicrobial within 72 hours from the initial order in the hospital (post-prescription review)? O Yes, in all wards O Yes, in selected wards only O Yes, in ICU only O No AHR = Alcohol hand rub; Number of beds assessed for presence of AHR dispensers and Number of beds assessed for occupancy at 00:01 on the day of PPS = denominator data, typically same number as the total number of beds in the hospital; ICU=intensive care unit. 24

25 Hospital data 3/3 European Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use Form H3. Hospital data 3/3 Hospital code: Survey dates: From / / To: / / dd / mm / yyyy dd / mm / yyyy Optional: ward indicators collected at hospital-wide level: Number of beds with AHR dispensers at point of care Number of beds assessed for presence of AHR dispensers Number of patient rooms in hospital Number of single patient rooms in hospital Number of single patient rooms with individual toilet and shower in hospital Number of beds occupied at 00:01 on the day of PPS Number of beds assessed for occupancy at 00:01 on the day of PPS Number Inc./ Total (1) (1) Data were collected for Included wards only (Inc = recommended) or for the total hospital (Tot); if all wards were included in PPS (Inc=Tot), mark Inc In your hospital, do healthcare workers (HCW) carry AHR dispensers (e.g. in their pockets)? (if yes, please estimate percentage) O No O >0-25% of HCW O >25-50% of HCW O >50-75% of HCW O >75% of HCW O Yes, percentage unknown Is there a formal procedure to review the appropriateness of an antimicrobial within 72 hours from the initial order in the hospital (post-prescription review)? O Yes, in all wards O Yes, in selected wards only O Yes, in ICU only O No AHR = Alcohol hand rub; Number of beds assessed for presence of AHR dispensers and Number of beds assessed for occupancy at 00:01 on the day of PPS = denominator data, typically same number as the total number of beds in the hospital; ICU=intensive care unit. 25

26 Til slutt Relevante dokumenter er sendt på epost og ligger på Frist for å levere prevalens 24. november forlenging mulig Spørsmål Sendes 26

27 Referanser 27

28 Spørsmålsrunde

Healthcare Acquired Infections

Healthcare Acquired Infections Emerging Trends in Hospital Administration 9 th & 10 th May 2014 Prof. Hannah Priya HICC In charge What is healthcare acquired infection? An infection occurring in a patient